National News

NC attorney general fights for Affordable Care Act at Supreme Court

Posted November 10, 2020 7:47 p.m. EST

— North Carolina is among 20 states that stood on the side of the Affordable Care Act at the U.S. Supreme Court on Tuesday.

The court took up the latest challenge to the decade-old health care law commonly known as "Obamacare," with Republican-led states and President Donald Trump's administration pushing to kill it off. A decision isn't expected for months.

"Our health care is an absolutely critical right, particularly so in a pandemic," said North Carolina Attorney Josh Stein, who filed a brief in support of the ACA.

The ACA has helped, among others, 4 million North Carolinians with pre-existing health conditions, 2 million seniors who have cheaper drug costs and 70,000 young adults who can remain on their parents' insurance until age 26, Stein said.

"If you have health insurance, you have a stake in the Affordable Care Act because your rates are impacted by how many other people are uninsured," he said, adding that treating more uninsured patients could leave many hospitals in financial crisis.

"This is a law that is integral to the entire health care system, and if the law's thrown out, the entire health care system is in jeopardy," he said.

The crux of the lawsuit involves the so-called individual mandate provision that requires people to have health coverage. Congress amended the law in 2017 to eliminate the tax penalty for failing to buy health insurance. Congress' taxing authority was key to helping the ACA survive its initial challenge years ago, and the Trump administration argued that the law is unconstitutional without that provision.

"This is neither a tax nor a constitutional mandate because nobody is harmed if the penalty is zero," said Scott Holmes, an associate professor of law at North Carolina Central University.

"It’s a pretty radical thing that the Republican attorneys general are asking the court to do – because there’s one provision that they argue is unconstitutional, they think the entire law should be struck down other than that one little piece," Stein said. "I’m hopeful that these politically conservative Supreme Court justices will act in a conservative fashion, which is to not strike down the entire law based on one provision."

Based on Tuesday's arguments, observers say the Supreme Court might leave the overall law in place. Chief Justice John Roberts and Justice Brett Kavanaugh suggested that it wasn't the court's role to invalidate the entire law, even if the individual mandate is deemed unconstitutional.

"This is a very straightforward case for severability under our precedents, meaning that we would excise the mandate and leave the rest of the act in place," Kavanagh said.

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